Reference : The repetition of behavioral assessments in diagnosis of disorders of consciousness.
Scientific journals : Article
Human health sciences : Neurology
http://hdl.handle.net/2268/218070
The repetition of behavioral assessments in diagnosis of disorders of consciousness.
English
Wannez, Sarah mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
Heine, Lizette mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
Thonnard, Marie [> >]
BODART, Olivier mailto [Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie >]
Annen, Jitka mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
Charland-Verville, Vanessa mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
Martens, Géraldine mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Aubinet, Charlène mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Martial, Charlotte mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
VANHAUDENHUYSE, Audrey mailto [Centre Hospitalier Universitaire de Liège - CHU > > Service d'algologie - soins palliatifs >]
Chatelle, Camille mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Thibaut, Aurore mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Schnakers, Caroline []
Demertzi, Athina mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
Gosseries, Olivia mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
LAUREYS, Steven mailto [Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie >]
2017
Annals of Neurology
81
6
883-889
Yes (verified by ORBi)
International
0364-5134
1531-8249
United States
[en] Adolescent ; Adult ; Aged ; Consciousness Disorders/diagnosis ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Time Factors ; Young Adult
[en] OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide guidelines regarding the number of assessments required for obtaining a reliable diagnosis. METHODS: One hundred twenty-three adult patients with chronic disorders of consciousness were referred to our tertiary center. They were assessed at least six times with the CRS-R within a 10-day period. Clinical diagnoses based on one, two, three, four, and five Coma Recovery Scale-Revised assessments were compared with a reference diagnosis (ie, the highest behavioral diagnosis obtained after six evaluations) using nonparametric statistics. Results were considered significant at p < 0.05 corrected for multiple comparisons. RESULTS: The number of assessments had a significant effect on the clinical diagnosis. Up to the fourth examination, the diagnosis was still statistically different from the reference diagnosis based on six CRS-R assessments. Compared to this reference diagnosis, the first evaluation led to 36% of misdiagnoses. INTERPRETATION: The number of CRS-R assessments has an impact on the clinical diagnosis of patients with chronic disorders of consciousness. Up to the fourth examinations, behavioral fluctuations may still impact the diagnostic accuracy. We here suggest performing at least five assessments in each patient with disorders of consciousness within a short time interval (eg, 2 weeks) to reduce misdiagnosis. Ann Neurol 2017;81:883-889 Ann Neurol 2017;81:883-889.
http://hdl.handle.net/2268/218070
10.1002/ana.24962
(c) 2017 American Neurological Association.

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